Undergraduate nursing simulation facilitators lived experience of facilitating reflection-in-action during high-fidelity simulation: A phenomenological study.

BACKGROUND: Reflective practice is an essential step to learning in high-fidelity simulation, yet, reflection-in-action is an often overlooked yet important opportunity to support student learning. OBJECTIVES: To explore and describe the lived experience of undergraduate nursing simulation facilitators use of reflection-in-action during high-fidelity simulation. DESIGN: A descriptive phenomenological study. SETTING: A western Canadian province. PARTICIPANTS: Undergraduate nursing simulation facilitators with experience in nursing education and simulation facilitation. METHODS: We conducted 11 semi-structured interviews and utilized Colaizzi's seven step process of analysis to discover the essence of undergraduate nursing simulation facilitators use of reflection-in-action during high-fidelity simulation. RESULTS: Simulation facilitators were able to identify reflection-in-action during high-fidelity simulation when students paused, collaborated, shared their thinking aloud, and changed their course of action. Barriers to reflection-in-action included learner fear and anxiety, poor simulation design, and inadequately prepared students and facilitators. Simulation facilitators supported reflection-in-action through prebriefing, facilitator curiosity, and providing cue, prompts, and facilitated paused. Some of the noted benefits to reflection-in-action include promoting collaborative learning, building confidence and critical thinking, and embedding reflection into practice. CONCLUSIONS: The insights from this research can be used to guide reflection-in-action strategy development and future research in high-fidelity simulation.

From Clinical Practice to Academic Student Instruction: Understanding the Clinical Instructor's Perspective Using a Mixed-Methods Approach.

BACKGROUND: Clinical instructors (CIs) are important to the provision of real-world experiential learning because they teach, mentor, and support students in clinical practice settings in higher education programs. CIs experience tensions that influence their retention and impact the sustainability of consistent, quality education for students. PURPOSE: The aim of this study was to examine the experiences of being a CI and how to better support them. METHODS: CIs in a nursing faculty at a Western Canadian university were approached to participate. Data collection included a survey (n = 17) with questions asking about the importance of and their ability to prepare, teach, and mentor nursing students in practice. Individual interviews (n = 6) and a focus group (n = 3) were conducted that asked CIs about their experiences and challenges. Analysis included descriptive statistics and thematic analysis. RESULTS: Participants indicated feeling unprepared entering the instructor role. Key findings were the need to improve CI orientation so that it is more practical and meaningful, to increase peer support from other instructors, and to assist CIs' transition into becoming educators. CONCLUSIONS: Understanding CIs' assessment of their needs can help institutions better support and retain them, promoting consistency and quality in practicum instruction.

Critical thinking instruction and technology enhanced learning from the student perspective: A mixed methods research study.

Critical thinking is acclaimed as a valuable asset for graduates from higher education programs. Technology has advanced in quantity and quality; recognized as a requirement of 21st century learners. A mixed methods research study was undertaken, examining undergraduate nursing student engagement with critical thinking instruction, platformed on two technology-enhanced learning environments: a classroom response system face-to-face in-class and an online discussion forum out-of-class. The Community of Inquiry framed the study capturing constructivist collaborative inquiry to support learning, and facilitate critical thinking capability. Inclusion of quantitative and qualitative data sources aimed to gather a comprehensive understanding of students' development of critical thinking and engagement with technology-enhanced learning. The findings from the students' perspectives were positive toward the inclusion of technology-enhanced learning, and use in supporting their development of critical thinking. Students considered the use of two forms of technology beneficial in meeting different needs and preferences, offering varied means to actively participate in learning. They valued critical thinking instruction being intentionally aligned with subject-specific content facilitating understanding, application, and relevance of course material. While the findings are limited to student participants, the instructional strategies and technology-enhanced learning identified as beneficial can inform course design for the development of critical thinking.